News & Commentary

Briefly Noted April 2017

Frank Diamond

Short-term health plans may be making a comeback, according to Kaiser Health News. These plans do not qualify as health plans under the ACA so the buyers don’t get the law’s premium tax credits and protections against the ban on pre-exisiting condition exclusions. But they’re popular, and may become more so as the ACA is replaced, because the premiums are lower than premiums for the ACA-approved plans.

The Boston Globe looks at how medicine’s being taught at the University of Vermont medical school, where “the professor has little to say” because the students must work together to find the answers. The Globe says the school offers medical education that produces the kind of doctor today’s patients need. “Toward that end, the school has pledged to eliminate all lectures by 2019,” the Globe reports.

Hospitals are penalized by CMS for readmissions under 30 days for six common conditions, including heart failure, pneumonia, and COPD. A study published in JAMA suggests that maybe sepsis should be added to that list. Researchers said that sepsis accounted for 12.2% of readmissions. Compare that with heart failure (6.7%), pneumonia (5%), COPD (4.6%), and heart attack (1.3%).

CMS-revised regulations governing nursing homes started going into effect last November, with more to be rolled out over the next few years. It’s the first time that regulations for long-term care facilities have been revised since 1991. One change is that “the rules allow people to receive any visitor they choose (not just relatives) whenever they choose, without restricted hours, as long as visitors don’t disturb other residents”.

The Veterans Choice and Accountability Act of 2014 included this simple goal: Use $2.5 billion of the allocated $16 billion to hire more staff to take care of veterans. NPR has been following the money and reports that there are about the same number of VA staff as when the law was passed.

A device that injects a life-saving dose of naloxone to save people who’ve overdosed on opioids has gone from $690 per two-pack in 2014 to $4,500, Kaiser Health News reports. The device, Evzio, is manufactured by a small drug company called Kaleo. It talks somebody through the process of injecting naloxone, which counteracts the harmful effects of heavy painkillers and heroin.

The ongoing debate about the effectiveness of wellness programs seems not to have registered with many who receive concierge care and the doctors who provide it, according to the Los Angeles Times. These doctors focus on wellness, not illness. “They work on health and fitness goals with their patients, and are available to speak with them regularly by cell phone to help them make better lifestyle choices,” the newspaper reports.

Getting patients to the hospital as soon as possible is good; even better is getting a patient’s information to the hospital right away. Paramedics with the Houston Fire Department consult with doctors through telehealth and electronic health records using iPads, reported Health Data Management. The program “is designed to reduce ambulance transport to the hospital, saving money and having more resources available when actual urgent emergencies arise”.

Pressure sores in hospitals have declined over the last decade, but not so in long-term care facilities, according to a study in the Journal of Wound, Ostomy and Continence Nursing. Pressure sore rates rose from 3.8% in 2013 to 5.4% in 2015.

Massachusetts is launching a program that’s meant to help infants and toddlers of parents addicted to opioids—yet one more indication of just how entrenched the nationwide opioid problem has become. The Boston Globe reports that “the government-funded initiative will pay for weekly home visits to 36 low-income families in New Bedford, a city south of Boston, where the number of children born with opiates in their bloodstreams is four times the state average”.

Thanks to the dismantling of the ACA, high-risk pools could very well make a comeback, the New York Times reports. High-risk programs separate people with pre-existing conditions or who are very ill—whose medical costs are likely to be high—from those who are relatively healthy. Before the ACA, 35 states had such programs in place. “Insurers could charge higher prices to those with existing medical conditions, but they would also rely on other sources of funding, including from the government, to cover their costs,” the Times reports. For some people, the high-risk programs worked—at least for a while. The Times relates a story about a couple paid $375 a month for a plan that covered breast cancer treatments. That high-risk program closed, and the couple had to search for a plan that met the requirements of the ACA.


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